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Aug. 18. 2015 4:04PM HAP Y BEE /VtW cva "Q I ' ':No. 2041, P. 26 <br /> ' '7arrr rar✓sur' <br /> San Joaquin County _ <br /> Environmental Health Department RE(,trvjiD <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.s*gov.org/ehd AUG 18 2015 <br /> Facility Name: Facility Phone: <br /> PERKOS CAFE (209) 832-4675 "Yf.E2WI1;ESFacility Address:1321 W ELEVENTH ST,TRACY,CA 95376 <br /> Inspection Contact: Title: Phone: <br /> Kim Montoya Manager (209)832-4675 <br /> Inspection Type: Program: <br /> ROUTINE INSPECTION-Operating Permit 1921 -HMBP-Regular-Primary Location <br /> Consent For: Consent Given By: <br /> O Inspection 0 Photos Q Samples I Kim Montoya, Manager <br /> CCR=California Code of Regulations HSC-Health and Safety Code CFR=Code of Federal Regulations <br /> V=Violation R=Repeal violation COS=Coneoledon site during lncpadio <br /> HSC 255D7 Failed to establish and implement a hazardous materials business plan ■V OR o COS <br /> HSC 28508(a)(1) Failed to electronically submit a business plan ■V OR o COS <br /> HSC 25508.2 Failed to annually review and cedify that the business plan is complete.accurate,and up to dale ■V OR o COS <br /> 4 HSC 25505.1 Failed to notify property owner that facility Is subject to and in compliance with the HMBP program o V o R o COS <br /> 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CaIOES Warning Center o V OR o COS <br /> HSC 25506(a)(1) Failed to complete and/or submit the Business Activities or owner/Operator identification page rr V OR o CCS <br /> 7 HSC 25505(a) Failed to complete and/or submit hazardous materials Inventory for all reportable materials on site mV OR o Cos <br /> 8 HSC 25608.1(a)-(e) Failed to submit revisions to HMBP within 30 days of change in business info or inventory o V OR o COS <br /> 9 HSC 25508.1(0 Failed to submit revisions to HMBP within 30 days of substantial change in operations o V OR o COS <br /> 0 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content ■V o R o COS <br /> 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures fora release or threatened release ■V OR o COS <br /> 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility ■V OR o COS <br /> 13 I HSC 26505(2)(4) Failed to provide or document initial and/or refresher training to appropriate personnel ■V OR o COS <br /> 14 HSC 25507.1 Failed to submit emergency response pian when not meeting Ag handler exemption requirements o V OR o COS <br /> 15 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements o V OR a COS <br /> 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unslalfed facility exemptions o V OR o COS <br /> 17 NSC 25511 Failed to submit a written response within 30 days of receiving an inspection report mV OR o COS <br /> 1010 See below Unlisted Administration/DDcumenlation violation OV OR OCOS <br /> 1040 See below Unlisted Rerease2eaka/Spills violation loV o R o COS <br /> 1=0 ME <br /> 1 0 <br /> Item q�� Remarks <br /> Received by Inspector: Phone: Date: <br /> (Initial)' PETER LOMBARDI. HM Specialist 1 (209) 953-6213 07/2712015 <br /> Pagel of 4 <br />